• Title/Summary/Keyword: Trauma Intensity

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Preemptive Use of Ketamine on Post Operative Pain of Appendectomy

  • Behdad, Akbar;Hosseinpour, Mehrdad;Khorasani, Parastoo
    • The Korean Journal of Pain
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    • v.24 no.3
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    • pp.137-140
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    • 2011
  • Background: Although early reviews of clinical findings were mostly negative, there is still a widespread belief for the efficacy of preemptive analgesia among clinicians. In this study, we evaluated whether the preemptive use of ketamine decreases post operative pain in patients undergoing appendectomy. Methods: In double-blind, randomized clinical trials, 80 adult male patients undergoing an operation for acute appendicitis were studied. Patients were randomly assigned to two groups. In the operating room, patients in the ketamine group received 0.5 mg/kg of ketamine IV 10 minutes before the surgical incision. In the control group, 0.5 mg/kg of normal saline was injected. The pain intensity was assessed at time 0 (immediately after arousal) and 4, 12, and 24 hours postoperatively using the 10 points visual analogue scale (VAS). Results: Eighty patients (40 for both groups) were enrolled in this study. For all of the evaluated times, the VAS score was significantly lower in the ketamine group compared to the control. The interval time for the first analgesic request was $23.1{\pm}6.7$ minutes for the case group and $18.1{\pm}7.3$ minutes for the control (P = 0.02). The total number of pethidine injections in the first 24 hours postoperatively was $0.6{\pm}0.6$ for the case group and $2.0{\pm}0.8$ for the controls (P = 0.032). There were no drug side effects for the case group. Conclusions: A low dose of intravenously administered ketamine had a preemptive effect in reducing pain after appendectomy.

A Case of Giant Epidermal Inclusion Cyst (거대 표피 낭종의 치험례)

  • Kim, Keun Sik;Cho, Pil Dong;Shin, Keuk Shun;Oh, Hwa Eun
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.803-806
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    • 2007
  • Purpose: The epidermal cyst is a very common skin lesion which usually occurs in the hairy regions. They are generally small but rarely reach more than 5 cm in diameter. We present a patient with a giant epidermal cyst on buttock area. Methods: A 50-year-old man with a slowly enlarging, huge mass in his left buttock was examined. There was no history of trauma in this area. Physical examination revealed a soft, nontender, $15{\times}15cm$-sized mass in his left buttock. T1-weighted magnetic resonance images demonstrated a well-circumscribed, multilocular cystic lesion with homogeneous, slightly high signal intensity. On T2-weighted images the lesion had wide areas of high signal intensity. The mass was totally excised. Results: A histopathological finding revealed that the cystic wall was lined with whole layers of stratified squamous epithelium. Keratin layers from the surface of the epithelium were seen to be sloughing into the cystic lumen. Multinucleted giant cells were found outside the cystic wall. Conclusion: Herein we report a rare case of giant epidermal cyst occurring on the buttock.

Unusual Presentation of Traumatic Neuroma of the Medial Plantar Nerve after Deep Laceration Mimicking a Foreign Body Granuloma: A Case Report (이물 육아종으로 오인된 심부 열상 이후 발생한 비정상적인 내측 족저 신경의 외상성 신경종: 증례 보고)

  • Woo, Seung Hun;Kim, Tae Woo;Bae, Jung Yun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.174-178
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    • 2017
  • Traumatic neuromas are rare benign tumors that are common after trauma or surgery and are usually accompanied by obvious symptoms of pain. Most reports show neuromas in the face, neck, and limbs, and the traumatic neuroma of the medial plantar nerve has rarely been reported. We encountered a traumatic neuroma of the medial plantar nerve after a deep laceration mimicking a foreign body granuloma. A small mass lesion was found around plantar aponeurosis with heterogeneous high signal intensity in the T2 fat suppression view and slightly enhanced intensity in the magnetic resonance imaging that suggested a foreign body granuloma. The lesion was diagnosed pathologically as a traumatic neuroma. A satisfactory clinical result was obtained after excision of the traumatic neuroma and burial of the proximal and distal stumps to the adjacent muscle at the secondary operation.

Importance of an Integrated Assessment of Functional Disability and Work Ability in Workers Affected by Low Back Pain

  • Fabrizio Russo;Cristina Di Tecco;Simone Russo;Giorgia Petrucci;Gianluca Vadala;Vincenzo Denaro;Sergio Iavicoli
    • Safety and Health at Work
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    • v.15 no.1
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    • pp.66-72
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    • 2024
  • Background: This study examines the relationship between functional disability and work ability in workers affected by low back pain (LBP) through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). The role of personal and work factors on functional disability/work ability levels has also been studied. LBP is the most common musculoskeletal problem and a major disabling health problem worldwide. Its etiology is multifactorial. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. Methods: A cohort of 264 patients affected by LBP from an Italian outpatient clinic were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data were collected during the first medical examination using anamnestic and clinical tools. The final sample is composed of 252 patients, 57.1% man, 44.0 % blue collars, 46.4% with the high school degree, 45.6% married. Results: WAI and ODI reported a negative and fair correlation (r = -0.454; p = .000). Workers with acute LBP symptoms have a higher probability of severe disability than those with chronic LBP symptoms. White collars without depressive symptoms reported higher work ability - even in chronic disability conditions-than those with depressive symptoms. Conclusion: The study found that ODI and WAI have a convergent validity and this suggests that the two tools measure capture distinctive aspects of disability related to personal, environmental, and occupational characteristics. The most important and modifiable prognostic factors found for ODI and WAI were depressive symptoms, workday absence, and intensity of back pain. The study also found a mild association between age and ODI. The study's findings highlight the importance of using a multidisciplinary approach to manage and prevent disability due to LBP.

Adrenal Hemorrhage in a Neonate (신생아의 부신 출혈)

  • Cho, Kyung-Ah;Yoo, Soo-Young
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.204-208
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    • 1995
  • Neonatal adrenal hemorrhage is frequently associated with birth trauma or perinatal hypoxia. Hemorrhagic necrosis of the adrenal glands is often found at autopsy and many small lesions are usually asymptomatic. A palpable abdominal mass and jaundice are the usual presenting signs. Ultrasound is very useful in the diagnosis of this lesion; however, if the mass has mixed echoic pattern, magnetic resonance imaging (MRl) is helpful for the differential diagnosis from neuroblastoma. We present the case of a female newborn who was found to have a abdominal mass on physical examination. The patient showed anemia and hyperbilirubinemia. An ultrasonogram disclosed a $3.8{\times}3.0$ cm suprarenal mass with mixed echoic pattern. The mass was initially suspected to be neuroblastoma. An abdominal computed tomogram was not able to differentiate the mass. Magnetic resonance imaging revealed markedly increased signal intensity on T1 and T2-weighted sequences. This finding was consistent with adrenal hemorrhage. Serial sonogram demonstrated the mass that resolved completely by 12 weeks of age.

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SEM Observation for the Damage of Inner Hair Cell Stereocilia of Guinea Pig Cochlea after Loud Tone Exposure (격음노출 후 기니픽 달팽이관 내유모세포 부동섬모에 관한 SEM(전자투사식현미경) 관측)

  • Jarng Soon Suck
    • The Journal of the Acoustical Society of Korea
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    • v.24 no.1E
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    • pp.1-6
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    • 2005
  • The inner hair cell stereocilia of the guinea pig cochlea was examined under a scanning electron microscope (SEM) after loud tone exposure onto the ear drum of the animal. Before and after guinea pigs were exposed to intensive and continuous tone such as 106 dB SPL in intensity, the functioning of the cochlea was monitored by N1-N2 audiograms. The structural damage of the stereocilia of inner hair cells (IHCs) and outer hair cells (OHCs) was examined using the SEM in x 1500 magnification. The comparison between the functional change of the cochlea and the structural damage of the IHC stereocilia is done by means of photographic observation. It can be shown that the functional change might be related to the structural damage of the IHC stereocilia after intensive acoustic trauma.

Spectral Computed Tomography: Fundamental Principles and Recent Developments

  • Aaron So;Savvas Nicolaou
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.86-96
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    • 2021
  • CT is a diagnostic tool with many clinical applications. The CT voxel intensity is related to the magnitude of X-ray attenuation, which is not unique to a given material. Substances with different chemical compositions can be represented by similar voxel intensities, making the classification of different tissue types challenging. Compared to the conventional single-energy CT, spectral CT is an emerging technology offering superior material differentiation, which is achieved using the energy dependence of X-ray attenuation in any material. A specific form of spectral CT is dual-energy imaging, in which an additional X-ray attenuation measurement is obtained at a second X-ray energy. Dual-energy CT has been implemented in clinical settings with great success. This paper reviews the theoretical basis and practical implementation of spectral/dual-energy CT.

Systematic Review of the Effects of Blood Flow Exercise for Health-care Promotion: A Focus on Korean Domestic Research (헬스케어 증진을 위한 혈류조절 가압 운동의 효과에 대한 체계적 문헌고찰 ; 국내 연구 중심으로)

  • Seo, Tae-Hwa;Kim, Dong-Won
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.447-454
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    • 2020
  • The purpose of this study was to determine the clinical effects of blood flow regulation exercise for improving patients' health care and its usefulness as a rehabilitation model for various diseases by analyzing and examining the existing literature. A literature review of Korean academic journals published over a 10-year period, from 2010 to 2019, was conducted using words such as "blood flow regulation," "blood flow restriction," "low-intensity exercise," and "Kaatsu." Kaatsu is a blood flow regulation exercise developed in 1966 by Dr. Yoshiaki Sato of Japan. It is an efficient and effective exercise method that uses blood flow regulation bands that increase the secretion of growth hormones to develop muscles within a short time, improves blood circulation and metabolism to prevent and improve adult diseases, shortens the rehabilitation period, and improves cardiovascular function. The study participants consisted of 10 patients, of whom four were elderly, four had obesity, one was a stroke patient, and one was a trauma patient. The results of this study show that the blood flow regulation exercise, which is a low-intensity exercise, has the same effect as high-intensity exercise, which supports the evidence that it is a highly efficient exercise method for muscle development and rehabilitation of the elderly, adolescents, and patients with injuries who have difficulty in general exercising. For future studies, further reviews are necessary to verify the effectiveness of the exercise method according to blood flow regulation site and type of disease.

A Clinical Experience of Nasopalatine Duct Cyst with Bony Defect (골결손을 동반한 비구개관 낭종의 치험례)

  • Kim, Young-Jin;Seo, Je-Won;Jun, Young-Joon;Kim, Sung-Sik
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.255-258
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    • 2005
  • The nasopalatine duct cyst, known as the incisive canal cyst, is the most common nonodontogenic cyst in the maxillofacial area. It is believed to arise from epithelial remnants of the embryonic nasopalatine duct. Nasopalatine duct cysts are most often detected in patients between forties and sixties. The trauma, bacterial infection, or mucous retention has been suggested as etiological factors. The cysts often present as asymptomatic swelling of the palate but can present with painful swelling or drainage. Radiologic findings include a well demarcated cystic structure in a round, ovoid or heart shape presenting with a well-defined bone defect in the anterior midline of the palate between and posterior to the central incisors. Most of them are less than 2cm in size. On MRI, the cyst is identified as a high-intensity, well-marginated lesion, which indicates that it contains proteinaceous material. We experienced a case of a 61-year-old female patient who had a $2.3{\times}2.6{\times}1.7cm$ sized nasopalatine duct cyst. The bony defect after a surgical extirpation was restored with hydroxyapatite. So we report a good results with some reviews of the literatures.

Total Spinal Block for Treatment of Post-traumatic Cervical Syndrome (외상성 경부 증후군의 치료를 위한 전척수신경차단의 효과)

  • Chang, Won-Young;Yoon, So-Young;Kim, Kyung-Bae;Choe, Kun-Chun
    • The Korean Journal of Pain
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    • v.6 no.1
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    • pp.109-116
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    • 1993
  • In March of l992, We performed two intentional total spinal blocks for the relief of pain. This was for 2 cases of post-traumatic cervical syndrome whose various symptoms were chronically unresponsive to the usual conservative treatments. We regularly checked the blood pressure, pulse rate, oxygen saturation and observed clinically the changes of respiration, consciousness, lid and light reflexes during the total spinal block. Pain relief was evaluated by using the Visual Analog Scale which is designed to measure the subjective intensity of pain. The results were as follows; 1) The effectiveness of total spinal block was 60% in case 1, 40% in case 2. 2) We observed two complications from the procedure. Firstly during the block, these were transient periods of hypotension. Following the block, accidental procedures related direct neural trauma resulted in anterior chest wall pain. In conclusion we believe that total spinal block is a satisfactory and reliable method for the treatment of post-traumatic cervical syndrome.

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